August 2018 (Issue 13)

Welcome

Welcome to the August 2018 Sexual Health & HIV Policy EUROBulletin.

Our eFeature in this edition is an interview with Marta Szostak. Marta is the co-ordinator of Astra, the Central and Eastern European Women's Network for Sexual and Reproductive Health and Rights. We spoke to Marta about the current situation for women and women’s rights organisations in the region.

The eastern Europe and central Asia region was also highlighted last month by the World Health Organization (WHO) as the only region in the world in which HIV infections are still on the rise. WHO is calling for urgent action to scale up the HIV response in this region. Research published in the Journal of Acquired Immune Deficiency Syndromes this month showed the disparity between regions. The European region overall is close to achieving the 90-90-90 targets set by UNAIDS, but the research found significant problems at each stage of the care continuum in eastern Europe.

The 22nd International AIDS Conference (AIDS 2018) was held in Amsterdam last month, and among many interesting research presentations, the PARTNER 2 study stood out. The researchers recruited gay couples for this study of HIV transmission risk and confirmed that the chance of any HIV-positive person with an undetectable viral load transmitting the virus to a sexual partner is scientifically equivalent to zero. The message Undetectable = Untransmittable (U=U) became the unofficial theme of the conference.

Other items to
look out for in this edition include: the European Court of Justice ruling on Truvada; and new WHO guidance for people involved in sexual and reproductive health research with adolescents.

Evidence, data & research

Europe close to meeting UNAIDS 90-90-90 target but considerable variability between countries

The European region of the World Health Organization (WHO) is close to achieving the UNAIDS 90-90-90 target, according to research published in the Journal of Acquired Immune Deficiency Syndromes. Data collected in 2016 showed that, overall, 81% of people with HIV had been diagnosed, 84% of diagnosed people were on antiretroviral therapy (ART) and 88% of ART-treated people were virally suppressed. But there was significant variation between European regions and also between countries within sub-regions.

Zero transmissions mean zero risk – PARTNER 2 study results announced

A key study presented to the AIDS 2018 conference confirmed that the chance of any HIV-positive person with an undetectable viral load transmitting the virus to a sexual partner is scientifically equivalent to zero. Results announced in 2014 from the first phase of the study, PARTNER 1, indicated that “Undetectable equals Untransmittable” (U=U), however, the statistical certainty of this result was not quite as convincing in the case of gay men, or for anal sex, as it was for vaginal sex. Results from PARTNER 2, which only recruited gay couples, indicated, in the words of the researchers, “A precise rate of within-couple transmission of zero” for gay men as well as for heterosexuals.

Long-term health perspectives of people living with HIV in Europe

The European AIDS Treatment Group (EATG) has published the
results of a survey investigating the attitudes and experiences of people
living with HIV in terms of their long-term health.

It found that almost half of respondents have another health
condition alongside HIV, with two-thirds of this group saying the other
condition impacted their health more than HIV. The survey also found that 40%
of respondents reported experiencing side-effects from their HIV treatment,
often affecting their quality of life, and not always discussed with their
health professionals.

First community report from EMIS 2017

A large survey of gay men and other men who have sex with men (MSM), the European MSM Internet Survey 2017 (EMIS), ran between October 2017 and January 2018. First results from the survey were presented at a meeting held to coincide with AIDS 2018, and the first in a series of community reports was also published. Final reports are expected in January 2019.

Reports & resources

WHO calls for urgent action to accelerate HIV response in eastern Europe and central Asia

Prior to the 22nd International AIDS Conference (AIDS 2018),
ministers of health and senior policy-makers from 10 countries in eastern
Europe and central Asia (EECA) gathered to call for increased political
commitment to scale up the HIV response. The World Health Organization (WHO)
European Region is the only WHO region where new HIV infections are increasing
and participants identified priorities for action, such as strengthening
collaboration across sectors and working in partnerships with civil society and
people living with HIV.

Following the dialogue, WHO Europe launched a Compendium of
good practices in the health sector response to HIV in the WHO European
Region.

Practical guidance for people involved in sexual and reproductive health research with adolescents

On International Youth Day (12 August), WHO released a new guidance document for people involved in sexual and reproductive health research with adolescents. The guidance includes case scenarios, which highlight common challenges faced by people involved in adolescent research, and how such challenges may be managed.

Guidance on preventing blood-borne viruses in prison settings

Prison settings have a higher burden of communicable
diseases such as hepatitis B (HBV), hepatitis C (HCV) and HIV. This is often
linked to people in prison settings having a history of injecting drugs, and can
also be linked to delayed diagnosis and poor medical facilities in prison
settings.

The European Centre for Disease Prevention and Control
(ECDC) and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)
have published joint public health guidance which outline evidence-based
measures to prevent and control the transmission of blood-borne viruses in
prison settings.

ECDC annual epidemiological reports

Earlier this month, the European Centre for Disease Prevention
and Control (ECDC) released its annual epidemiological reports for 2016, including
reports covering several sexually transmitted infections.

Sexual health rights & advocacy

The All of Us manifesto

All of Us, the European Parliament's
pro-choice network, has published a manifesto, urging the European Union and
its member states to proactively support women's rights, ensuring reproductive
health rights and opposing laws and policies that undermine them

IPPF in Eastern Europe and Central Asia

The International Planned Parenthood Federation European Network (IPPF EN) has released a report covering their HIV, sexual health and reproductive health work in Eastern Europe and Central Asia. Called, IPPF EN cares: Supporting neglected communities in Eastern Europe and Central Asia, the report highlights young people from marginalised groups who are most vulnerable to HIV, in a region where the HIV epidemic continues to grow.

Treatment & service guidelines

Training manual – HIV and HCV rapid testing

The Joint Action on HIV and Co-infection Prevention and Harm Reduction (HA-REACT) project has published a new training manual on rapid testing for HIV and hepatitis C virus (HCV). The manual is written for staff working with people who use drugs and aims to provide relevant knowledge, skills and techniques. It consists of eight modules and is freely available to download as a PDF.

Parliament & other European institutions

European Court of Justice ruling on Truvada

In July, a decision by the European Court of Justice paved
the way for generic versions of the drug Truvada,
used for HIV treatment and prevention (as pre-exposure prophylaxis, or PrEP) to
become more widely available. The patent for Truvada expired in July 2017, but a patent extension (supplementary
protection certificate) was applied in several European countries. The court
ruled that the extension is invalid.

PACE report on the persecution of LGBTI people in the Chechen Republic

The Parliamentary Assembly of the Council of Europe (PACE)
has adopted a report on the Persecution of LGBTI people in the Chechen Republic
(Russian Federation). It calls for an independent investigation into the persecution
of LGBTI people and calls on member states to provide protection to people fleeing
persecution. It follows media reports of abduction, arbitrary detention and
torture of men presumed to be gay.

Campaigns & other news

The Ljubljana Declaration

A group of European networks and organisations have launched the Ljubljana Declaration 2.0, an update to the 2008 original, calling for urgent action in response to rapidly expanding HIV epidemics among men who have sex with men and trans people in newer EU member states and enlargement countries. It calls for action from governments, the European Commission and UNAIDS, urging them to live up to their commitments to leave no one behind in the fight against HIV.

In Guatemala, the slogan is “Indetectable = Intransmisible” (I=I); in the Netherlands, it’s “Niet meetbaar = Niet overdraagbaar” (N=N); and in Turkey, “Belirlenemeyen = Bulaştırmayan” (B=B). One of the most striking aspects of the pre-conference on “Undetectable = Untransmittable” (U=U), held in advance of the 22nd International AIDS Conference (AIDS 2018) in Amsterdam, was the extent to which the campaign has energised advocates around the world.

Portugal

Russia

Serbia

The European Society of Contraception and Reproductive Health (ESC) is holding a 'teach the teacher' course to improve and facilitate knowledge about contraception and reproductive health care. The course will be held in Belgrade in November - register by 15 September.

Ukraine

United Kingdom

NAM is an award-winning, community-based organisation, which works from the UK. We deliver reliable and accurate HIV information across the world to HIV-positive people and to the professionals who treat, support and care for them.